Advancements in Psoriasis Treatments

Psoriasis is a condition near and dear to Alice Gottlieb, MD, PhD, clinical professor and medical director at the Icahn School of Medicine at Mount Sinai in New York, New York. Gottlieb’s mother was diagnosed with the condition, and she had the opportunity to conduct research and develop one of the drugs to help her mother live a more comfortable life. In her session “What’s New in Psoriasis” at the 2024 Masterclasses in Dermatology conference, she shed light on the current landscape of psoriasis treatments, categorizing them by class and emphasizing the exciting developments in the field.¹

In the realm of interleukin (IL) 17 inhibitors, Gottlieb highlighted the approval of bimekizumab (Bimzelx) in the United States, an IL-17 A and F blocker with European approval for psoriatic arthritis. She expressed enthusiasm for the data surrounding its efficacy in treating psoriasis.

Turning to secukinumab (Cosentyx), Gottlieb noted the introduction of an intravenous formulation for psoriatic arthritis and ankylosing spondylitis. She underscored the significance of this formulation for Medicare patients, providing access to an IL-17 blocker that was previously financially out of reach due to high coinsurance costs.

Addressing IL-23 blockers, Gottlieb referenced recent data published in the New England Journal, discussing an oral IL-23 receptor antagonist. This new oral option presents a compelling addition to the psoriasis treatment arsenal.²

Discussing TNF blockers, Gottlieb delved into the world of biosimilars, emphasizing the variability among them. She draws attention to the differences between deucravacitinib (Sotyktu) and apremilast (Otezla) through comparative studies. In a comprehensive analysis of five randomized controlled trials involving 2198 individuals with moderate to severe plaque psoriasis, deucravacitinib demonstrated significant superiority over placebo and apremilast across key parameters, including PASI scores and DLQI, with enduring efficacy observed in 52-week studies. Safety evaluation indicated commendable tolerability, with a low and balanced incidence of adverse events, serious adverse events, and treatment discontinuation, highlighting deucravacitinib's favorable safety profile for those dealing with moderate to severe plaque psoriasis.³

Gottlieb emphasized the evolving landscape of psoriasis treatments, asserting that dermatologists now have a range of choices for highly effective and safer options, both in biologics and orals. She passionately advocates for patients' right to choose clearance and safe clearance, emphasizing the progress made since the early days of her career.

She also underscored the crucial role dermatologists play in the early detection of psoriatic arthritis, aiming to prevent disability and enhance patients' quality of life. She emphasizes the joint teaching efforts focusing on the prevention of disability due to psoriatic arthritis.

References

1. Gottlieb A. What's new in psoriasis. Presented at: Masterclasses in Dermatology February 16-19, 2024; Puerto Rico.
2. R Bissonnette, A Pinter, MD, K Papp, et al. An oral interleukin-23–receptor antagonist peptide for plaque psoriasis. The New England Journal of Medicine. February 7, 2024. Accessed February 17, 2024.https://www.nejm.org/doi/full/10.1056/NEJMoa2308713.
3. Qiu J, Liu J, Liu W, Lin F, Shi N. The efficacy and safety of tyrosine kinase 2 inhibitor deucravacitinib in the treatment of plaque psoriasis: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2023;10:1264667. Published 2023 Sep 29. doi:10.3389/fmed.2023.1264667